自体干细胞移植前后磁共振成像的变化与多发性骨髓瘤的反应和生存相关。
Changes in magnetic resonance imaging before and after autologous stem cell transplantation correlate with response and survival in multiple myeloma.
机构信息
Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.
出版信息
Haematologica. 2012 Nov;97(11):1757-60. doi: 10.3324/haematol.2012.065359. Epub 2012 Jun 11.
Abstract
In multiple myeloma, focal lesions, as well as diffuse and variegated infiltration patterns, can be detected by magnetic resonance imaging. In the current study, we compared treatment response in 100 myeloma patients with changes in infiltration patterns in whole body magnetic resonance imaging before and after autologous stem cell transplantation. We found an agreement between serological response and changes in imaging (P<0.001). In detail, a significant agreement of treatment response was observed for diffuse (P=0.004) as well as for focal (P=0.01) infiltration patterns. The number of focal lesions at second magnetic resonance imaging was of prognostic significance for overall survival (P=0.001). We conclude that treatment response in myeloma goes along with a decrease in imaging findings. We suggest that residual disease after high-dose chemotherapy detected by magnetic resonance imaging increases the risk of relapse. Therefore, myeloma patients with such findings after treatment might benefit from further cytoreduction.
摘要
在多发性骨髓瘤中，磁共振成像可检测到局灶性病变以及弥漫性和斑驳性浸润模式。在本研究中，我们比较了 100 例多发性骨髓瘤患者在自体干细胞移植前后全身磁共振成像浸润模式变化时的治疗反应。我们发现血清学反应与影像学变化之间存在一致性（P<0.001）。具体而言，弥漫性（P=0.004）和局灶性（P=0.01）浸润模式的治疗反应具有显著一致性。第二次磁共振成像时的局灶性病变数量对总生存具有预后意义（P=0.001）。我们得出结论，多发性骨髓瘤的治疗反应与影像学发现的减少有关。我们建议，高剂量化疗后磁共振成像检测到的残留疾病会增加复发的风险。因此，治疗后出现这些发现的骨髓瘤患者可能会从进一步的细胞减灭中受益。
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